Adjuvanted vaccine could improve flu protection and slash GP workload

Switching to an adjuvanted flu vaccine next flu season could slash GP visits from elderly patients by 21,800 a year and prevent 1,700 deaths, researchers have said.

Flu jab: overhaul planned (Photo: Jim Varney)
Flu jab: overhaul planned (Photo: Jim Varney)

Data presented at the European Scientific Working group on Influenza (ESWI) on Tuesday found that switching to an adjuvanted vaccine could help prevent 175,000 cases of influenza.

It comes amid growing concern over the vaccination programme. Data from PHE has revealed that the flu vaccine had ‘no significant effectiveness’ in patients over 65 in the last flu season.

The Joint Committee for Vaccinations and Immunisations (JCVI), which advises the government on vaccinations, described the results as ‘disappointing’, warning that it appears to be the latest in an emerging trend for lower effectiveness against the H3N2 flu strain in this age group.

H3N2 has dominated recent seasons, and the committee has decided that ‘proper consideration’ on the benefits of the over-65s programme should take place.

It has brought forward plans on ‘reviewing the entire programme’, which were initially set to take place in 2020, once the paediatric programme had been fully rolled out in primary schools.

Flu vaccination

This will also allow it to consider the new influenza vaccines, including the adjuvanted vaccine, which are incoming to the UK market, it said.

UK GPs are able to pre-order the adjuvanted vaccine for the 2018/19 flu season onwards. Modelling suggests it is more effective in the elderly compared to traditional flu vaccines, especially during years where there is a mismatch between the flu strains in the vaccine and those circulating in the real world.

The vaccine uses an adjuvant which helps the body’s immune system develop a strong response to flu, and has been specifically designed for people over 65 whose immune systems are weakening through immunosenescence.

RCGP national immunisation lead Dr George Kassianos told GPonline: 'The only thing we can do as GPs is order the adjuvanted vaccine for next year. It is really the best we have at the moment for the elderly, it covers much better than the conventional vaccine, but we haven't got it this year - I wish we did.

'It has also been shown to work on the drifting H3N2 strain and the antibodies last for longer and at a much higher level. We are heading towards reducing GP consultations and respiratory attendance to emergency departments.'

He added that the best time to vaccinate elderly patients is late October to early November, which should ensure they still have high numbers of antibodies when the virus hits its peak in mid-January and February.

Lead author of the ESWI study Dr James Mansi said: ‘Influenza in older adults is often particularly severe, due in part to their ageing immune systems which mean that vaccines don’t produce an optimal immune response.

‘These results predict that the immunisation of older adults with aTIV rather than a standard influenza vaccine would results in improved protection against influenza in the over-65s. These data are consistent with previous findings where aTIV was shown to provide significantly improved protection against influenza in older adults.’

The JCVI added that a greater focus should be made on ‘rolling out and improving uptake’ in the paediatric programme to help protect elderly patients.

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